What is it about?
This prospective comparative study examined whether adding structured Kegel exercises to high-intensity focused electromagnetic pelvic floor stimulation (EMSELLA) was associated with better urinary incontinence outcomes in postmenopausal women. The study included 99 women with stress or mixed urinary incontinence. Forty-nine received EMSELLA alone, while 50 received EMSELLA combined with a structured Kegel exercise program. Both groups underwent six EMSELLA sessions over three weeks. The combined-treatment group also performed Kegel exercises twice daily for three months, continuing the exercises after the electromagnetic stimulation sessions had ended. Urinary symptoms were assessed at baseline and after three months using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF). Both groups reported symptom improvement. The combined-treatment group had a modest additional advantage after adjustment for baseline severity, with a difference of 0.68 points favoring the combined approach. The proportion of women meeting the study's predefined criteria for clinically meaningful improvement was 76.0% in the combined-treatment group and 57.1% in the EMSELLA-only group. These findings suggest a potential short-term benefit from incorporating structured pelvic floor exercises into electromagnetic stimulation-based rehabilitation. Longer-term and more rigorously controlled studies are needed.
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Why is it important?
Urinary incontinence can substantially affect daily activities, social participation, and quality of life in postmenopausal women. Pelvic floor muscle training is an established conservative treatment, while high-intensity focused electromagnetic stimulation is an additional non-invasive rehabilitation approach whose comparative effectiveness requires further investigation. This study provides clinical data on a combined rehabilitation program involving electromagnetic stimulation and structured Kegel exercises. Although outcomes favored the combined intervention, the adjusted difference in symptom scores was relatively small. The study also cannot separate the potential contribution of continued exercise training from any interaction between the two treatment methods. Its main value lies in identifying a clinically relevant research question and providing preliminary comparative findings that may inform the design of future studies. Further investigations should include longer follow-up, objective pelvic floor function measurements, and additional comparison groups to clarify the individual and combined effects of these interventions.
Perspectives
As a co-author of this study and a physician specializing in Physical Medicine, Rehabilitation, and Balneology, I consider individualized, non-invasive rehabilitation strategies an important area of research in women's health. The findings suggest that combining electromagnetic pelvic floor stimulation with a structured Kegel exercise program may offer additional short-term symptom improvement compared with electromagnetic stimulation alone. However, the modest adjusted treatment difference and the absence of separate exercise-only and sham-stimulation groups require cautious interpretation. An important direction for future research is understanding how supervised treatment, continued patient participation, and exercise adherence contribute to rehabilitation outcomes. This study complements our previous research on urinary incontinence during menopause and supports further investigation of evidence-based pelvic floor rehabilitation strategies.
Dr Traian Virgiliu Surdu
Universitatea Ovidius din Constanta
Read the Original
This page is a summary of: Efficacy of Combining Kegel Exercises with EMS-Based Pelvic Floor Muscle Electrostimulation in Postmenopausal Women with Involuntary Urinary Leakage, Clinics and Practice, April 2026, MDPI AG,
DOI: 10.3390/clinpract16050085.
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